Assessment of endothelial dysfunction in young healthy first-degree relatives with family history of premature coronary artery disease using vascular doppler ultrasonography

Background: Endothelial dysfunction in young healthy first-degree relatives with family history of premature coronary artery disease was assessed in the present study using vascular doppler ultrasonography.Methods: Thirty young (10-40 years) first degree relatives of 17 patients with premature CAD without risk factors were selected for the study. Age and gender matched healthy subjects were enrolled as controls. Non- invasive assessment of endothelial dysfunction was done by vascular doppler study of brachial artery. Brachial artery diameter, velocity and blood flow were estimated in every study subject and control at rest, after stress and again at rest and after glyceryl-trinitrate (GTN) by vascular Doppler ultrasonography.Results: The percent rise in lumen diameter of brachial artery after stress i.e. reactive hyperaemia, labelled as percent rise in flow mediated dilatation (FMD), was significantly lower in family history group than in controls (8.42±3.47% vs 12.22±4.31%, p0.05).Conclusions: Apparently healthy young subjects with family history of premature CAD have impaired endothelium dependent FMD in systemic circulation. Simple, non-invasive, cost-effective vascular doppler ultrasonography is recommended as a potential screening tool to detect subclinical atherosclerosis

Multiple Widespread Blue Nodules: A Clinicopathological Case

Glomangiomas are a variant of benign glomus tumours; glomus tumours are benign neoplastic proliferations of the glomus body, which is made up of perivascular smooth muscle cells. This forms arteriovenous anastomoses which play an important role in vascular regulation of skin temperature. The aim of this article is to describe 2 cases of hereditary glomangiomas

A rare case of spinal hydatid cyst (echinococcosis) presenting with paraparesis

Spinal hydatid cysts, although rare, can lead to debilitating neurological deficits if not promptly diagnosed and managed. We present an intriguing case of a 60-year-old male who presented with sudden-onset paraplegia, an unusual manifestation of spinal hydatid disease. The clinical complexity of paraplegia prompted a comprehensive diagnostic journey involving clinical, and radiological evaluations. Imaging studies unveiled a large hydatid cyst within the spinal canal, with epidural extension compressing the spinal cord. Surgical intervention was undertaken, and the cyst was successfully excised, leading to partial neurological recovery. This case serves as a reminder of the diverse clinical presentations of hydatid cysts and highlights the significance of maintaining a high index of suspicion in endemic regions. Early diagnosis, tailored management, and heightened awareness are pivotal in averting irreversible neurological damage and enhancing patient outcomes in such challenging cases

British Association of Dermatologists guidelines for the management of people with vitiligo 2021

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of vitiligo. The document aims to: offer an appraisal of all relevant literature up to May 2019, focusing on any key developments address important, practical clinical questions relating to the primary guideline objective provide guideline recommendations and if appropriate research recommendations

The IASLC Early Lung Imaging Confederation (ELIC) Open-Source Deep Learning and Quantitative Measurement Initiative.

BackgroundWith global adoption of CT lung cancer screening, there is increasing interest to use artificial intelligence (AI) deep learning methods to improve the clinical management process. To enable AI research using an open source, cloud-based, globally distributed, screening CT imaging dataset and computational environment that are compliant with the most stringent international privacy regulations that also protects the intellectual properties of researchers, the International Association of the Study of Lung Cancer (IASLC) sponsored development of the Early Lung Imaging Confederation (ELIC) resource in 2018. The objective of this report is to describe the updated capabilities of ELIC and illustrate how this resource can be utilized for clinically relevant AI research.MethodsIn this second Phase of the initiative, metadata and screening CT scans from two time points were collected from 100 screening participants in seven countries. An automated deep learning AI lung segmentation algorithm, automated quantitative emphysema metrics, and a quantitative lung nodule volume measurement algorithm were run on these scans.ResultsA total of 1,394 CTs were collected from 697 participants. The LAV950 quantitative emphysema metric was found to be potentially useful in distinguishing lung cancer from benign cases using a combined slice thickness ≥ 2.5 mm. Lung nodule volume change measurements had better sensitivity and specificity for classifying malignant from benign lung nodules when applied to solid lung nodules from high quality CT scans.ConclusionThese initial experiments demonstrated that ELIC can support deep learning AI and quantitative imaging analyses on diverse and globally distributed cloud-based datasets

Intradialytic Heparin Reduction & Validation of Extracorporeal Circuit Subjective Clotting Scale Study

Unfractionated heparin (UFH) use during dialysis has a narrow therapeutic window; if misjudged the dose administered by nurses based on visual assessment of post dialysis clotting and hemostasis time can cause adverse bleeding or ill effects in these patients. The purpose of this MN thesis prospective study was to examine the efficacy of a new heparin protocol. Specific research questions included: 1) Will the use of a more aggressive heparin-reduction protocol reduce the cumulative heparin dosage in chronic hemodialysis (HD) patients, 2) Is there a relationship between the dialyzer clotting scale and the ultrasound based FBV measurement, and 3) Is the visual dialyzer clotting scale used for the study reliable? Use of the study protocol significantly reduced cumulative heparin dose (p=<0.001); without affecting KT/V (F(5,55)=1.67, p=.157) or leading to extracorporeal circuit loss. Inter-rater reliability was evident between study nurse dialyzer scores (p=0.688) but there was no intra-rater reliability between study nurse and or clinical nurse educator/hemodialysis nurses

Discrimination in child protection work: recurring themes in work with Asian families

© 1999 Blackwell Science. Publisher PDF version is restricted access in accordance with the Blackwell policy.When the relationships within the institutions and social practices of a society cannot be explained by the intentions, good or bad, of individual men and women, they can be described as structural (Weedon 1987, p. 3). This paper reports on research in a Midlands Social Services Department which examined child protection practice in relation to Asian families who had attended case conferences. The research shows that in spite of the good intentions of many individual workers, Asian families experienced a discriminatory service. Discriminatory policies and practices were perpetuated at an organizational level. Three themes from the research are explored: the use of interpreters, the accommodation of children, and the lack of attention to the mental and physical health of the child’s mother and father. Each theme is explored to highlight the issues which Asian families faced and the problems which created barriers to good practice